Provider Demographics
NPI:1417247388
Name:LEARNING FOR LIFE DEVELOPMENT CENTER, LLC
Entity Type:Organization
Organization Name:LEARNING FOR LIFE DEVELOPMENT CENTER, LLC
Other - Org Name:C/O LISA RADER, MA, BCBA
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:RADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-686-1505
Mailing Address - Street 1:4 SOUTH ORANGE AVENUE
Mailing Address - Street 2:APT 2231 BOX 189
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1782
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 SOUTH ORANGE AVENUE
Practice Address - Street 2:APT 2231 BOX 189
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-1782
Practice Address - Country:US
Practice Address - Phone:908-686-1505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty